Cialis is indicated for the treatment of erectile dysfunction. Cialis is a phosphodiesterase type 5 (PDE5) inhibitor. It works by helping to increase blood flow into the penis during sexual stimulation. This helps you to achieve and maintain an erection.

INSTRUCTIONS

Use Cialis as directed by your doctor.

Take Cialis by mouth with or without food.

For use as needed: Take Cialis at least 30 minutes before sexual activity, as directed by your doctor. Cialis may work for up to 36 hours after you take it.

For daily use: Take Cialis regularly at about the same time each day.

Check with your doctor before you eat grapefruit or drink grapefruit juice while you are taking Cialis.

For use as needed: If you miss a dose of Cialis and you still intend to engage in sexual activity, take it as soon as you remember. Continue to take it as directed by your doctor. For daily use: If you miss a dose of Cialis, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

DOSAGE

For Use As Needed

The recommended starting dose of Cialis for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity.

The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients.

Cialis for use as needed was shown to improve erectile function compared to placebo up to 36 hours following dosing. Therefore, when advising patients on optimal use of Cialis, this should be taken into consideration.

For Once Daily Use

The recommended starting dose of Cialis for once daily use is 2.5 mg, taken at approximately the same time every day, without regard to timing of sexual activity.

The Cialis dose for once daily use may be increased to 5 mg, based on individual efficacy and tolerability.

Ask your health care provider any questions you may have about how to use Cialis.

STORAGE

Store Cialis at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Cialis out of the reach of children and away from pets.

you have had a heart attack within the past 90 days or you have had severe heart failure or a stroke within the past 6 months

you are taking a nitrate (eg, isosorbide, nitroglycerin) in any form (eg, tablet, capsule, patch, ointment), or nitroprusside

you have been advised by your doctor to avoid sexual activity because of heart problems

you use certain recreational drugs called "poppers" (eg, amyl nitrate or nitrite, butyl nitrate or nitrite)

you take another PDE5 inhibitor (eg, sildenafil, vardenafil) or another medicine that contains tadalafil.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Cialis. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

if you have allergies to medicines, foods, or other substances

if you have a deformed penis (eg, Peyronie disease, cavernosal fibrosis), blood cell problems (eg, sickle cell anemia, leukemia, multiple myeloma), or any other condition that may increase the risk of a prolonged erection (priapism)

if you have a history of a prolonged (more than 4 hours) or painful erection (priapism)

Barbiturates (eg, phenobarbital), carbamazepine, phenytoin, or rifampin because they may decrease Cialis's effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cialis may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

Cialis may cause dizziness, drowsiness, fainting, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Cialis with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.

Cialis may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.

Do not drink large amounts of alcohol (eg, 5 drinks or more) while you take Cialis. Doing so may increase your risk of dizziness, headache, fast heartbeat, and low blood pressure.

Patients with heart problems who take Cialis may be at increased risk for heart-related side effects, including heart attack or stroke. Symptoms of a heart attack may include chest, shoulder, neck, or jaw pain; numbness of an arm or leg; severe dizziness, headache, nausea, stomach pain, or vomiting; fainting; or vision changes. Symptoms of a stroke may include confusion; vision or speech changes; one-sided weakness; or fainting. Contact your doctor or seek medical attention right away if you experience these symptoms.

Cialis may rarely cause a prolonged (eg, more than 4 hours) or painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.

Cialis does not stop the spread of HIV or other sexually transmitted diseases (STDs) to others through sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection or an STD.

Cialis will not prevent pregnancy. If your partner may become pregnant and you wish to avoid pregnancy, be sure to use an effective form of birth control.

Rarely, an eye problem called nonarteritic anterior ischemic optic neuropathy (NAION) has been reported in patients who took Cialis. This may lead to decreased vision or permanent loss of vision in some cases. If you notice a sudden decrease in vision or loss of vision in one or both eyes, contact your doctor right away.

Sudden decreases in hearing and loss of hearing have been reported in some patients who have taken Cialis. Sometimes they also noticed ringing in the ears or dizziness. If you notice a sudden decrease or loss of hearing, contact your doctor right away.

Do not use other medicines or treatments for ED while you are taking Cialis without first checking with your doctor.

Use Cialis with caution in the elderly; they may be more sensitive to its effects.

Cialis is not recommended for use in children younger 18 years.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome: